NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, London, UK.
Division of Imaging, Informatics and Data Sciences, The University of Manchester, Manchester, UK.
Sleep Med. 2017 Apr;32:129-136. doi: 10.1016/j.sleep.2016.12.018. Epub 2017 Jan 16.
To investigate the prevalence of insomnia and identify associated demographic, clinical and forensic risk factors in adult prisoners in England.
A cross-sectional study of 237 prisoners aged 18-72 years, across two male prisons and one female prison in North England. We used the Sleep Condition Indicator to measure probable DSM-V insomnia disorder (ID) and the Pittsburgh Sleep Quality Index to examine sleep quality. Multiple demographic, sleep, clinical and forensic self-reported measures were recorded to identify any associations with insomnia.
Overall, the prevalence of possible DSM-V ID was 61.6% (95% CI, 55.5%-67.8%). Subjective poor sleep quality was reported by 88.2% (95% CI, 84.1%-92.3%). Seven in ten (70.6%) female prisoners had possible DSM-V ID (95% CI, 64.8%-76.4%). Multivariable logistic regression analysis, adjusting for gender and age, indicated odds of having possible ID in prison were increased for the following factors: history of physical ill-health (OR = 3.62, 95% CI, 1.31-9.98); suicidality (OR = 2.79, 95% CI, 1.01.7.66), previously asked for help for insomnia (OR = 2.58, 95% CI, 1.21-5.47), depression (OR = 2.06, 95% CI 1.31-3.24), greater endorsement of dysfunctional beliefs about sleep (OR = 1.50, 95% CI, 1.21-1.87), poor sleep hygiene (OR = 1.11, 95% CI, 1.04-1.19), and problematic prison environment (eg, noise, light or temperature) (OR = 1.07, 95% CI, 1.02-1.12).
For the first time we have established the prevalence and associated factors of insomnia in a large sample of adult English prisoners. ID and poor sleep quality are common, especially in female prisoners. These findings emphasize/amplify the need for dedicated treatment pathways to improve screening, assessment and treatment of insomnia in prison.
调查英格兰成年囚犯失眠的患病率，并确定相关的人口统计学、临床和法医风险因素。
这是一项在英格兰北部的两所男监狱和一所女监狱中进行的 237 名 18-72 岁囚犯的横断面研究。我们使用睡眠状况指标来衡量可能的 DSM-V 失眠障碍（ID），并用匹兹堡睡眠质量指数来检查睡眠质量。记录了多种人口统计学、睡眠、临床和法医自我报告的措施，以确定与失眠相关的任何因素。
总体而言，可能的 DSM-V ID 的患病率为 61.6%（95%CI，55.5%-67.8%）。报告主观睡眠质量差的比例为 88.2%（95%CI，84.1%-92.3%）。十分之七的女性囚犯（95%CI，64.8%-76.4%）可能患有 DSM-V ID。多变量逻辑回归分析，调整性别和年龄因素后，在以下因素中，监狱中存在 ID 的可能性增加：身体不健康史（OR=3.62，95%CI，1.31-9.98）；自杀意念（OR=2.79，95%CI，1.01-7.66），曾因失眠寻求帮助（OR=2.58，95%CI，1.21-5.47），抑郁（OR=2.06，95%CI 1.31-3.24），对睡眠功能障碍信念的更多认可（OR=1.50，95%CI，1.21-1.87），不良的睡眠卫生（OR=1.11，95%CI，1.04-1.19），以及有问题的监狱环境（例如，噪音、光线或温度）（OR=1.07，95%CI，1.02-1.12）。
我们首次在一个大型的英国成年囚犯样本中确定了失眠的患病率及其相关因素。ID 和睡眠质量差很常见，尤其是在女性囚犯中。这些发现强调/放大了需要专门的治疗途径，以改善监狱中失眠的筛查、评估和治疗。
